Lingual Artery and Hyoglossus — MFDS Part 1 MCQ

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HardAnatomy (Head & Neck)Lingual Artery and HyoglossusMFDS Part 1

During transoral resection of the lateral tongue base, the hypoglossal nerve is identified and protected on the external surface of the hyoglossus muscle. The surgeon then divides the hyoglossus to continue medially towards the genioglossus. Which structure is most likely to be encountered between these two muscles?

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Correct answer: A — Lingual artery

The correct answer is **A, the lingual artery**. Its main trunk passes medial (deep) to hyoglossus, lying against the lateral surface of genioglossus; dividing hyoglossus therefore risks significant arterial haemorrhage. The hypoglossal nerve is an important contrasting landmark because it crosses the external surface of hyoglossus. The lingual nerve and submandibular duct also lie in the superficial floor-of-mouth plane lateral to hyoglossus rather than between hyoglossus and genioglossus. The sublingual gland occupies the sublingual space above mylohyoid and is likewise lateral to hyoglossus. The operative direction and named muscular plane therefore distinguish the lingual artery from the other clinically vulnerable floor-of-mouth structures.

Reference: Dallan I, et al. Anatomical landmarks for transoral robotic tongue base surgery: comparison between endoscopic, external and radiological perspectives. Surgical and Radiologic Anatomy. 2013;35:3–10. https://pubmed.ncbi.nlm.nih.gov/22644779/